Is medical school possible during BEP. Help!

[2828]

Hello anyone willing to offer advice!

I'm new to the forum. It is surprising how often you hear that around here. This forum has been an incredible resource for my family. Thank you to all members who keep it going.

I was diagnosed recently with bilateral EC. After my second IO, my HCG kept rising (22, 27, 49), so now I’m facing 3 rounds of BEP (5 day regimen). I start therapy next week (8/13). The dilemma I am faced with is that I am supposed to begin my second year of medical school on 8/27. I can take a leave of absence, however it would have to be an entire year because the 2nd year at my school builds on previous coursework, and there is no time next summer to remediate, as I will have to take boards and begin clinical rotations at the end of the year. Additionally, I am on an Air Force scholarship that pays a stipend and my health insurance while in school. If I take a leave of absence from school I don’t get the stipend from the Air Force, putting a serious financial burden on my family.

So, I was wondering if anyone who has experienced BEP could tell me if they think attending school is possible during treatment. Med school is very rigorous mentally, but I am sincere when I say that I thrive off of my education, and learning is one of my greatest delights. I’m sure that BEP affects everybody differently, but I wanted to gauge the thoughts of those who have experienced it. For what it is worth, I am 30 years old, in excellent shape and have a high tolerance for pain. However, I am a total puss when it comes to nausea, so I was curious how often people had to deal with that.

Any thoughts would be greatly appreciated!

[nciungan]

Becoming an Oncologist??? I bet you would have a lot of wisdom to share after your own experience with treatment.

Boy, this is a tuffy. All side effects aside, I don't know how you would possibly attend classes during the long weeks where you are in the chair for the greater part of a day (5 hours) for 5 days in a row.

I can tell you I had a lot of aspirations during my treatment since I was going to have so much time on my hands. I wanted to learn Spanish or start to learn a programming language. Both went to crap after I started. The effects are cumulative, so you'll probably feel worse and worse as you go along. The first few weeks you might think 'oh I could totally do this' but the fatigue got pretty bad for me and the only thing I wanted to do was sleep. I would think the stress alone of trying to do any type of school, let alone med school, would be too much to handle but that is just my opinion.

[2828]

Thanks for your reply Neil. I appreciate your thoughts and your blog! Reading about your experience on your blog makes me realize that I have an uphill journey ahead of me. Your insight is exactly what I was after, so thank you!

And, yes, oncology has suddenly become very interesting to me

[nciungan]

To answer one of your other questions, nausea was not much if an issue. They have so many anti-nausea meds that you should not be puking. Sometimes you may have an upset stomach but for me it didn't happen until round 3.

Best of luck with your schooling. I dont want to deter you from trying to tough it out because I'm sure if I REALLY had to work or do something to support a family my mindset would have been different.

[Ny01]

It's really a crap shoot. Some people have been able to retain somewhat of normal lives and others not remotely close. I wouldn't worry about the nausea too much as what Neil above says is true, the drugs control it well. But, the cumulative part of BEP and the randomness of side effects would make me hesitate to attempt trying to take on a new school program. I was able to do a ton of work from home/hospital and attend many conference calls other than a few weeks of misery. The weeks of misery were definitely total misery and no chance of doing much besides feel horrible and tired. What would happen if you started your semester and you couldn't cope due to illness from chemo? If you could somehow get the tuition back if you have to bail out, then you might want to try to gamble on it as the end result would be the same. It's a very tough call and for me, I don't think I could do it with the complications I had. The studying wouldn't be the difficult part, it would be the class time in some of the bad weeks toward the end. Good luck and know we are all rooting for you and will try to answer questions basedon our experiences. FYI, I'm 7-8 weeks out of BEP and have been working full time in my office 3-4 weeks after my last Bleo infusion.

Regards,

Rob

[Davepet]

I know I would not have been able to study effectively. I had extreme fatigue & would drop off to sleep anytime I had a chance. Also a bit of that brain fog called "chemo brain".

Nausea was no problem for me, the IV drugs given on the longs weeks were completely effective. I got a bit queasy on the weekends afterwards, but the oral drugs took care of that pretty well.

How soon do you have to decide? You will have a week after your first long week to see how it's affecting you. If you can defer the decision until the 23rd or 24th, you'll have a better idea of what to do.

Are you sure there are no exceptions on the stipend for medical emergencies?

Dave

[Smartie]

I know guys who were able to work through much of their treatment. Of course, it was not possible for them to do so during the week of their infusions. I personally took the whole time off, plus about six weeks after finishing chemo too. That was the right decision for me. There were times at which I was too wiped out to pick up a coffee cup, let alone work or study. However, there were other times when I felt fine and felt a little guilty about being off work.
During my treatment I contracted an unidentified infection on two occasions. I was placed in isolation, given IV anti-biotics and 'barrier nursed'. I felt swful and was in a serious condition. This was in spite of doing all I could to avoid sources of infection. Assuming you would need to spend time in a hospital as part of the course, it's perhaps worth considering if that would put you at too much of a risk of catching something.

If I hadn't had the infections, I think it would have been impossible for me to work during the time that I was having the actual treatment, plus about another three days per cycle.

In spite of all the reasons to avoid working that I've given, I rather hope you do find a way to do it. One more thing to consider: Here in England BEP is routinely administered using a three-day regimen. There is no difference in efficacy, but it is associated with a slightly greater risk of longer-term side effects. Could you get them to consiider switching to that regimen, iin order to leave a little more time for you?

[TonyTigger]

I just recently finished BEPx3 and I could have attended school for the first cycle but for the last 6 weeks I could not. I had constant nausea and even a shower would wear me out. Also during the last two cycles I could not focus enough to read more than the news and sports on the web. But you are younger than I am and everyone is different, some on the site have been able to work on their Bleo weeks.

[2828]

Wow. Thank you all so much for your input. It really is the toughest decision I have ever had to make. I think I will attempt school, as I am able to withdraw up to 10 days into the quarter with no penalty. My biggest worry is that I will be feeling great at the start of the quarter, then decide to press on, only to have the compound effects of the chemo catch up with me. After 10 days into the quarter, I will be responsible for my performance. The school has said it will try to back me up however possible. As for the Air Force, I need to talk to them about whether or not they can help me out with this. I'm pretty sure they cannot pay my stipend if I am not enrolled in school.

The general consensus seems to be that, later in treatment it will be very difficult to do much other than rest.

Thanks again for all the replies. If anyone else has thoughts or advice, I would love to hear it.

[evstar18]

I went to university part time during my BEP, I think if you can handle cancer mentally, you might be able to deal with it during med school. I couldn't handle cancer mentally very well, the mental burden was easily the worst in comparison to the other side effects. You are right in being concerned about the cumulative effects, by the last treatment I wasn't too happy and I had very little physical strength. However, you might be able to do it? Tough call, I'd say take the year off, you have cancer, but others would heavily disagree.

I think it really depends on what the penalties are for dropping out after 10 days. Sometimes treatments don't go perfectly as expected and you may end up needing a pc-rplnd or perhaps even salvage chemo (However in the end you will be fine either way ). Talk to your registrar and explain the situation and see what they say and what accommodations can be made for you!

[evstar18]

after having written that I feel remorseful. If you want to try to go to school while undergoing therapy go for it! Don't let me stop you!. Ask a well spoken surgical oncologist what they think in an email. They could shed some light on the topic. !!!

[TCdoc]

Tough call. If you are determined to keep going to med school then you can do it. However, it won't be an easy ride. As others have said the last cycle is really where it knocks you out for a while.

Last year the daughter of some friends developed lymphoma and have to have chemo. She took a year of med school and it didn't do her any harm. I took a year out before starting med school just to get experience of the world before going back to further education. Is there really a rush . . .


PS I also know someone who I trained with who changed from doing an Arts degree to doing medicine and who is now a professor of pediatric oncology in Colorado.

[Terrorr]

I’m going to med school just like you. I started my chemo at the last 2 weeks of the summer semester. During the 5 days I went to school in the morning and to chemo after that. I didn’t had any big side effects ( just a little nausea in the mornings ) that would prevent me from going to, but I did missed some classes because I couldn’t attend classes that were in the afternoon. I even went to two big exams ( Immunology and physiology ) and passed them both without any problems. Just after my 3rd round ends the third year will begin for me.

Right now while I’m on my 2nd cycle I’m learning biochemistry. It mostly depends on you how you will feel, but it is manageable whit a little support from your faculty. Besides me, there was also one more student on my year that was going through chemo and he was feeling just fine.

During my 1st cycle I was even able to go to the gym, run on the lakeside, drive bicycle and do some exercises at home and I really didn’t had no side effects. I think it mostly depends on your physical condition and since you mentioned that you’re in good shape, there is a high possibility that you could go to school while receiving chemo.

Just don’t let chemo and TC take over your mind ! Don’t let it be the ˝center ˝ of your life in the next 9 weeks. While you’re sitting 6 hours in the hospital try not to focus on the chemo. While I was on my first round I was always trying to learn from med books for exams and I think it helped me much not to feel sick. Yesterday my oncologist told me that the low WBC count could be because I exhausted my body with gym training, running and too much learning. So I was relaxing a whole day, eating fatty food and fruit-shakes … and in 24h my wbc count raised close to normal ranges.

I would strongly suggest you to go to school, unless you gonna feel really bad after chemo. I f you maybe feel uncomfortable with being bald, I would suggest you buying a male wig. I did get one, but I’m not using it yet.

I see that you’re starting second year … I don’t know from what country your are and what exams you have ( probably biochemistry, physiology, histology … ) but if it’s similar to mine second year curriculum, then the second year is a little bit easier than the first one.

[dihmy]

Terrorr , i think you are absolutely correct. the key is not to make TC the center of our lives.
im going for chemo first cycle next week and im afraid how i will spend the next three months. should i take a vacation and have a rest at home ? should i travel somewhere ? or should i go to work like everyday, however im afraid that this will cause me to have some infections. its a difficult decision.

anyway i hope that we all be fine after this and its sure that we will become more stronger from inside to face life. TC experience is like a small battle and we are its warriors.

[hbr777]

I think you all have a great mental attitude of not letting TC and its treatments rule your lives. However, if indeed the treatment does change your daily life, it is not because you are not strong. This is a treatment that is tough, mentally and physically. There seems to be no good predictors of how people will do. Young or old, Type A or Type B - the only way to know is right about the time of the end of the first cycle. Some people can work - others cannot. There is a guy on here who practiced dentistry through his treatment; my husband could hardly climb a flight of stairs, and could not stay awake.

This is nine weeks of something that is so personal, and so unknown. Everyone has a unique experience. There are some givens; around day 6 you'll be feeling not so great. Bleo days can make you at a minimum very tired, or shake and bake. You'll lose your hair around day 20. And you'll be tired, progressively so as treatment goes on. Some people can concentrate, others cannot. Everyone starts out with the intention doing everything normally. But if you cannot, please know that you are not alone, and totally normal.

I wish you both the best of luck on your chemo journey and godspeed on your return to good health!

[S P]

Dude I feel your pain here. This is tough, and my wife is a doctor so I know how tough the 2nd year of medical school is. Her stress levels were insane. Unfortunately you're going to have to play it by ear. Everybody responds to chemo differently. Some barely miss a beat, but it can really put a beating on others. More than a few end up in the ER for various things. There's also "chemo brain" to consider. I just wasn't as sharp mentally for a few months after I was done with chemo, which could very well affect your med school coursework.

You would be very lucky if you could get through BEP and your course work at the same time. Very luck. The safe bet is to withdraw for the year, get through the chemo, allow yourself time to recover, and regroup for next year. One thing though, very important, talk to all of the advisors at your school and tell them what's going on. Rules tend to never be set in stone in academia. Maybe you could attempt, but if you couldn't handle it still allow you to withdraw late? The effects of chemo are cumulative. My first two rounds [of EPx4] were ok, but my body just couldn't keep up and the last two rounds really put me out of commission.